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Transformations: Countertransference During the Psychoanalytic Treatment of Incest, Real and Imagined (1996)
Siegel, Elaine V.
Routledge / The Analytic Press / Softcover / 2019-01-01 / 1138872342
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In recent years, memories and reconstructions of incestuous child abuse have become common features of psychoanalytic treatment. Among some clinicians, such abuse is suspected even when there is little evidence. How does the analyst distinguish between incest real and imagined, and how do recovered memories of incest affect the analyst?

In this poignant and beautifully written study, Elaine Siegel brings new insights to bear on these timely questions. An inveterate note taker, she discloses the countertransferential ruminations and associations to the occurrence of incest at various stages during the treatment process over the course of 30 years of clinical work. The manner in which her "analytic instrument" evolved and was shaped by her analysands' stories makes for a fascinating subtext in a book that addresses itself to the differences and similarities during treatment of real and imagined incestuous abuse.

Among the powrfully disturbing clinical cases at the heart of this study are two reports detailing the lengthy analyses of women who found corroboration for multigenerational incest. Siegel also presents two cases in which patients retracted their claims of incest toward the end of their treatments. Through the medium of these and other reports, Siegel explores how psychoanalysts are struggling both to understand incestuous abuse and to accomodate their treatment techniques to shifting societal perspectives.


"In instructive and moving ways, Siegel describes how her work with these patients led to an acceptance of her own multifaceted bodily reactions and accompanying images as an essential aspect of her work ego. Transformations meets an urgent need for detailed clinical material on treatment, including not only cases of father-daughter incest, but those rarer instances of incest committed by mothers both with daughters and with sons. Readers will resonate with Siegel's reactions of horror to these patients' stories. Still, she is to be commended for not advocating a separate diagnostic category for these patients, sensitive as she is to individual differences among them on the basis of gender, life history, and particular ego strength."
- Jean Sanville, Ph.D., Los Angeles Institute for Psychoanalytic Studies

"Elaine Siegel's outstanding, eminently readable book provides what is probably the most comprehensive clinical account of both the intrapsychic and interactional processes occurring in the analyses of patients who are incest victims. Further, Transformations develops an original approach for using the clinician's countertransferences, including somatic reactions, to attain a deeper understanding of what is taking place unconsciously in the patient. I wholeheartedly recommend this book to all practitioners who want to learn more about contemporary treatment methods."
- Theo L. Dorpat, M.D., Training Analyst, Seattle Institute for Psychoanalysis

“Siegel relied on sensitive attunement to her bodily posture, sounds, and psychophysiological reactions in treatment hours as a guide to intuiting and interpreting the patient’s bodily memories of physical violation. She concludes that countertransference responses, especially somatically derived ones, are important guides to helping patients establish the transitional space pivotal in the reconstruction and working through of traumatic memories.”
- Kathryn J. Zerbe, JAPA


Introduction. Multigenerational Incest-Mrs. Raphael. Multigenerational Incest-Mrs. Hutchcomb. Mother-Son Incest. Father-Daughter Incest. False Claims of Incest. Epilogue.

About the Author:

Elaine Siegel, Ph.D., ADTR, has been supervising and training analyst at the New York Center for Psychoanalytic Training. A registered dance therapist, she was the director of the motor development unit at Suffolk Child Development Center (SUNY, Stony Brook) for 14 years. She now lectures extensively in the United States and Europe. She is widely published in German and English, and her books include Female Homosexuality, Middle-Class Waifs (both published by Analytic Press), and Angewandte Tanztherapie.

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